Patients’ preferences for postmenopausal hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer treatments in Japan

BACKGROUND: This study aimed to identify factors affecting patients’ preferences for postmenopausal hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer treatments, their relative importance, and impact of sociodemographic/clinical characteristics. METHODS: Japanese postmenopausal patients with HR+ breast cancer chose between 2 hypothetical treatments for HR+/HER2− advanced breast cancer using an online discrete choice experiment, defined by different levels of 5 attributes: progression-free survival (PFS), incidence of diarrhea (IOD), frequency of loose stools of grade 1–3 severity (FOS), duration of diarrhea (DOD), and route/frequency of administration (RFA). Conditional logit modeling identified relative preferences for each attribute. Subgroup analyses, based on sociodemographic characteristics (age, employment status, age of youngest child, marital status) and clinical characteristics (relapse/metastasis, hormone sensitivity), identified factors affecting preferences. RESULTS: Of 896 participants screened, 258 eligible participants were included in analyses. Patient preferences, when the potential frequency of diarrhea was grade 2, were (strongest to weakest): PFS, DOD, FOS, IOD, RFA; however, when the potential frequency of diarrhea was grade 3, FOS became most important. Sociodemographic/clinical characteristics tended to affect preferences. CONCLUSIONS: Japanese postmenopausal patients with HR+ breast cancer preferred treatments that extend PFS despite potential grade 2 diarrhea. However, when diarrhea severity increased to grade 3, patients were more willing to sacrifice PFS to avoid more frequent diarrhea. Prevention or limitation of diarrhea to grade ≤ 2 is important for maintaining patients’ motivation for treatment that can extend PFS. Additionally, patient characteristics (age, family context, therapeutic experience) should be considered during treatment choice. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12282-019-00965-4) contains supplementary material, which is available to authorized users.